Patient Health Resource: Colorectal Cancer

Risk

Some people are more likely to get colorectal cancer than others. The top risk factors for colorectal cancer include:

• Age — Risk increases as you get older.
• Race — African Americans have an increased risk of getting colorectal cancer (and dying from it) than people of other races.
• Family history — Having a history of colorectal cancer in your family or having a rare inherited polyp syndrome, such as Lynch syndrome or familial adenomatous polyposis (FAP).
• Health history — Having ulcerative colitis, Crohn’s disease or inflammatory bowel disease. Having had one or more polyps removed from your colon.
• Lifestyle factors — Smoking, lack of physical activity, drinking large amounts of alcohol, or consuming red and processed meats.

Experts agree that people who have a higher risk for colorectal cancer may need to be tested sooner. Talk to your doctor about when you should be tested. Your doctor may recommend testing earlier or more often.

Prevention

Cancers in the colon or rectum usually grow very slowly. In most cases, it takes years for them to grow large enough to cause symptoms.

While you may not be able to control all risk factors, you may be able to lower your risk by taking steps to improve your overall health. Talk with your doctor to understand your level of risk and discuss whether you need a screening.

How can you help prevent colorectal cancer?

There are lifestyle actions you can take to lower some of the risk factors for colorectal cancer. These actions include the following:

• Maintain a healthy weight.
• Be physically active.
• Eat healthy foods, including vegetables, fruits and whole grains. Avoid eating a lot of red meat or processed meats.
• If you smoke, get help to quit.
• If you drink alcohol, limit how much you drink.

Signs and symptoms

Most people who develop colon cancer do not have any signs or symptoms before the cancer starts is diagnosed. This is why colon cancer screening is recommended even when someone feels perfectly fine. The goal of colon cancer screening is to detect any abnormalities early so the cancer can be removed before it becomes a threat to someone’s life.

Most colon cancers develop from colon polyps, which are small growths. Many people who have a colon polyp do not have any symptoms. Colon polyps are common and, although most do not turn into cancer, some polyps can turn into cancer over time. If they are found early, usually through routine screening tests, they can be removed before they do.

Colorectal cancer in its early stages usually doesn't cause any symptoms. Symptoms occur later, when the cancer may be harder to treat. The most common symptoms include:

• Blood in your stool or very dark stools.
• A change in your bowel habits, such as having more frequent bowel movements or a feeling that your bowels aren't emptying completely.
• Low energy (fatigue).
• Pain in the belly or rectal pain.

Detection

Your risk for colorectal cancer gets higher as you get older. Screening for colon cancer is recommended for an average-risk adult between the ages of 45 to 75 years old. 

For people with increased risk, additional screening before the age of 45 and after the age of 75may be recommended. Talk with your doctor about your risk factors and when to start and stop screening.

What are the best ways to screen for or detect colon cancer?

Although there are different screening tests to detect colon cancer, the best test is the test that you can get done.

The most common colon cancer screening tests are:

• Colonoscopy — a camera used to see part or all of the colon. If everything appears normal during the procedure, an average-risk person may only need to do this screening every 10 years.
• Stool-based tests — a stool sample is collected and sent to a laboratory to test for signs of colon cancer, such as blood that is not visible to the naked eye or abnormal DNA. If the tests results are normal, an average-risk person may only need to do this screening every 1 to 3 years.
• CT colonography — also known as a “virtual colonoscopy”, is a CT scan that uses x-rays to look for abnormalities in the colon that may be due to colon cancer or a large colon polyp that may need to be removed. This test may not be covered by all health insurance plans, which may make this test more expensive than a colonoscopy or a stool-based test (see above).

Treatment

Treatment for colorectal cancer is based on the stage and location of the cancer. It's also based on other things, such as your overall health. The main treatments are:

• Surgery — In most cases, the doctor removes part of the colon or rectum and sews the healthy ends back together. Sometimes a small area of cancer can be removed during a colonoscopy.
• Chemotherapy — These medicines kill fast-growing cells, including cancer cells and some normal cells. They may be given after surgery to help destroy any cancer cells that remain.
• Radiation therapy — This uses high-dose X-rays to destroy cancer cells and shrink tumors. It may be combined with surgery. Chemotherapy and radiation may be given together. (This is called chemoradiation.)

In some cases, targeted therapy or immunotherapy may be an option. A clinical trial may be a good choice.

Your doctor will talk with you about your options before making a treatment plan.

Source: Healthwise